Hospitals go for rotation policy, a third of staff at any given time

Learning a lesson, top public hospitals in India — AIIMS Delhi, Jodhpur and Bhopal, Safdarjung and Lok Nayak among them — have adopted a rotation formula where the staff, including doctors and nurses, have been divided in three groups: A, B and C.

TNN

March 28, 2020, 05:41 IST

Representative image New Delhi: Should hospitals follow all-hands-on-the-deck approach when a pandemic is knocking on the door? Italy did it. But if one healthcare worker caught the novel coronavirus infection, others, too, had to be quarantined, leading to manpower shortage.

Learning a lesson, top public hospitals in India — AIIMS Delhi, Jodhpur and Bhopal, Safdarjung and Lok Nayak among them — have adopted a rotation formula where the staff, including doctors and nurses, have been divided in three groups: A, B and C. After working for a week, group A goes on stand by for two weeks, while B and C groups also follow the same pattern.

This way, an official said, even if one group falls sick or requires quarantining, the others can take over. “The formula ensures social distancing in hospitals, enhances our level of preparedness and saves on important resources such as personal protective equipment (PPE),” Dr Randeep Guleria, director of AIIMS-Delhi, said.

Echoing him, Dr Sarman Singh, director of AIIMS-Bhopal, said, “We have also made similar arrangements for doctors looking after Covid-19 patients.”

According to an order issued by AIIMS-Jodhpur, the departmental heads “may plan availability of manpower in such a manner that at any given point of time, 30% of the total manpower or as per requirement remains available at the workplace”.

Dr J C Passey, the acting head of Lok Nayak Hospital where six Covid-19 patients are admitted, said they had also adopted a similar policy. “Healthcare workers are at the maximum risk to contract the infection from patients. We have to strategise to reduce it and the rotatory formula is one such plan. It also helps reduce the need for PPEs,” he said.

Although the hospital has enough stock of PPEs for now, there may be a problem in future as manufacturers are not accepting bulk orders because of short of stock, Dr Passey added.

Many hospitals across the country are facing the problem. A senior resident doctor at Nalanda Medical College and Hospital in Patna, a designated Covid-19 hospital, claimed the WHO-recommended hazmat suits, an impermeable whole-body garment to be worn by healthcare staff while dealing with suspected or positive patients, “aren’t available here”. He also stressed on more intense fumigation or sanitisation drives on the campus.

Health experts say India must learn from the countries where the pandemic has killed many, including many healthcare workers. Italy, for example, has lost 45 doctors, according to the Italian Association of Doctors. Filippo Anelli, its president, on Thursday made an urgent call for protective equipment.

According to the Italian National Institute of Health, since the beginning of the pandemic in Italy, which is among the worst affected countries, over 6,000 health workers have been infected.

The virus recently claimed the life of 57-year-old doctor Marcello Natali, who had repeatedly sounded the alarm about Italy’s failing response to the crisis, state media reports. “We weren’t prepared for novel coronavirus,” Natali, regional chief of the Federation of General Practitioners, had told in his interviews and warned about the lack of medical supplies required to fight the highly contagious virus.

“Adequate protection, rest and prophylaxis medicines, as advised by regulatory bodies, are essential to ensure that our healthcare workers don’t become a victim of the disease. They are needed, more than ever, to win this fight,” Dr S K Sarin, the director of Institute of Liver and Biliary Sciences, told TOI.

Dr Sarin is the head of the five-member committee that has prepared the roadmap for Covid-19 control and pateint management in the capital.

Sponsored Stories

Subscribe to our Newsletters

When the blood reaches these curves, it makes changes to its fluid mechanics and interactions with the vessel wall. In a healthy person, these changes are in harmony with the tortuous microenvironment, but when diseased, these environments could lead to very complex flow conditions that activate proteins and cells that eventually lead to blood clots.